From the Department of Paediatric Immunology & Infectious Diseases.
NIHR Biomedical Research Centre.
Pediatr Infect Dis J. 2018 Dec;37(12):e292-e297. doi: 10.1097/INF.0000000000002031.
Recent advances in outpatient parenteral antibiotic therapy (OPAT) have largely focused on adult practice, and there are few published data on the safety and effectiveness of pediatric OPAT (p-OPAT).
During a 3-year period (2012 to 2015), data were prospectively collected on patients managed within the p-OPAT service at Southampton Children's Hospital, a tertiary pediatric hospital in the South of England.
A total of 130 p-OPAT episodes were managed during this period. The most frequently managed pathologies were bone and joint infections (44.6%), followed by ear, nose and throat (10.7%), respiratory (10.0%) and central nervous system (10.0%) infections. The most frequently used antimicrobial agent was ceftriaxone (n = 103; 79.2%). For the majority of p-OPAT episodes, antimicrobials were delivered in prefilled syringes (n = 109; 83.8%); 24-hour infusions administered by elastomeric devices were used less commonly (n = 16; 12.3%). The median duration of p-OPAT treatment was 9.2 days (interquartile range: 7.6-19.0 days). With regard to patient outcomes, 113 (86.9%) p-OPAT episodes resulted in cure and 12 (9.2%) in improvement; treatment failure occurred in 5 (3.9%) episodes. Intravenous catheter-related complications were rare. A total of 1683 bed days were saved over the 3-year period.
Our data suggest that p-OPAT is safe and effective, with the potential to offer considerable savings for the healthcare economy through reduced length of inpatient stay.
近年来，门诊静脉用抗生素治疗（OPAT）取得了很大进展，主要集中在成人实践方面，而关于儿科 OPAT（p-OPAT）的安全性和有效性的发表数据很少。
在 3 年期间（2012 年至 2015 年），在英格兰南部的一家三级儿科医院南安普顿儿童医院的 p-OPAT 服务中，前瞻性地收集了管理患者的数据。
在此期间共管理了 130 例 p-OPAT 发作。最常见的治疗疾病是骨骼和关节感染（44.6%），其次是耳鼻喉（10.7%），呼吸道（10.0%）和中枢神经系统（10.0%）感染。最常用的抗菌药物是头孢曲松（n = 103；79.2%）。对于大多数 p-OPAT 发作，抗生素以预装注射器（n = 109；83.8%）给药；较少使用弹性装置进行 24 小时输注（n = 16；12.3%）。p-OPAT 治疗的中位持续时间为 9.2 天（四分位间距：7.6-19.0 天）。就患者结局而言，113 例（86.9%）p-OPAT 发作治愈，12 例（9.2%）好转；5 例（3.9%）治疗失败。静脉内导管相关并发症罕见。在 3 年期间共节省了 1683 个床位日。
我们的数据表明，p-OPAT 是安全有效的，有可能通过减少住院时间为医疗保健经济带来可观的节省。
